Tartara F, Gaetani P, Tancioni F, Guagliano A, Klersy C, Forlino A, Marzatico F, Rodriguez y Baena R
Department of Neurosurgery, IRCCS Policlinico S Matteo, Italy.
Life Sci. 1996;59(1):15-20. doi: 10.1016/0024-3205(96)00263-9.
An altered equilibrium of protease/protease-inhibitor factors may be involved in the pathogenesis of aneurysm rupture: alpha 1-antitrypsin (alpha 1-AT) represents the most relevant inhibitor of elastase, a proteolytic enzyme enhancing catabolic processes of collagen metabolism. In the present study we test the hypothesis whether the activity of alpha 1-AT is altered in SAH patients; 5 cases with unruptured intracranial aneurysm and 27 patients with diagnosis of aneurysm SAH were included in the study. Blood samples were obtained immediately at admission. As control samples we consider the 5 cases of unruptured aneurysm, 15 cases of unruptured aortic aneurysms and 10 patients with non-vascular CNS diseases. Measurement of alpha 1-AT level was determined by immunoturbidimetric method. Serum levels of alpha 1-AT are significantly lower in patients admitted within 72 hours after SAH, if compared to patients admitted in a delayed phase. The linear relationship between alpha 1-AT and collagenase inhibitory percentage capacity (CIC) was shown to be different in the 4 subgroups considered, and so were the mean % CIC values in the between-groups comparison, except for unruptured aneurysm vs controls. The alpha 1-AT CIC in patients with SAH is shown to be the lowest when compared to controls and unruptured aneurysms (p = 0.0001).
蛋白酶/蛋白酶抑制剂因子的平衡改变可能与动脉瘤破裂的发病机制有关：α1-抗胰蛋白酶（α1-AT）是弹性蛋白酶最主要的抑制剂，弹性蛋白酶是一种增强胶原代谢分解过程的蛋白水解酶。在本研究中，我们检验了SAH患者中α1-AT活性是否改变的假设；研究纳入了5例未破裂颅内动脉瘤患者和27例诊断为动脉瘤性SAH的患者。入院时立即采集血样。作为对照样本，我们选取了5例未破裂动脉瘤患者、15例未破裂主动脉瘤患者和10例非血管性中枢神经系统疾病患者。α1-AT水平通过免疫比浊法测定。与延迟期入院的患者相比，SAH后72小时内入院的患者血清α1-AT水平显著降低。在考虑的4个亚组中，α1-AT与胶原酶抑制百分比能力（CIC）之间的线性关系有所不同，组间比较中的平均CIC值也是如此，但未破裂动脉瘤组与对照组除外。与对照组和未破裂动脉瘤相比，SAH患者的α1-AT CIC最低（p = 0.0001）。
